Insights & Discussion
Compared with usual care, acupuncture resulted in significant improvement in chemotherapy-induced peripheral neuropathy symptoms.
We found therapeutic benefit of real acupuncture for neuropathic pain that is consistent with previous pilot acupuncture CIPN trials. Distinctively, our study is the first, to our knowledge, to incorporate a sham treatment and a nontreatment control to evaluate the efficacy of acupuncture for CIPN.
The addition of a sham acupuncture control in an acupuncture clinical trial is difficult owing to the challenge of incorporating a truly inert placebo. In addition, a sham control limits the ability of a small effect size to elucidate a true difference between real and sham acupuncture.
Not only did our study demonstrate the feasibility of conducting a sham-controlled acupuncture trial, it generated sufficient pilot data to inform a definitive sham-controlled efficacy trial. Our trial is limited by its small sample size, single center, and short-term follow-up.
Discover Related Insights
Acupuncture has been shown to be more effective than vitamin B treatment in terms of clinical efficacy rate for chemotherapy induced peripheral neuropathy.
2020 Medicine A systematic review and meta-analysis of the efficacy of acupuncture and electroacupuncture against chemotherapy-induced peripheral neuropathy Hwang MS, Lee HY, Choi TY, et al.
Systematic Review Chemotherapy-Induced Peripheral Neuropathy
Aside from 1 study using sham-EA as a control group, all 12 studies included acupuncture versus pharmacological treatments. The results showed that acupuncture could show a superior clinical efficacy than vitamin B therapy. However, the methodological quality of the involved studies was generally low.
Acupuncture, regardless of the trial design, showed a positive effect on pain-related outcome measures for participants with diabetic peripheral neuropathy.
2019 Acupuncture in Medicine Acupuncture for the treatment of lower limb diabetic peripheral neuropathy: a systematic review Nash J, Armour M, Penkala S
Systematic Review Chronic Pain Peripheral Neuropathy
Acupuncture, regardless of the trial design, showed a positive effect on pain-related outcome measures for participants with DPN. However, a meta-analysis could not be performed owing to the highly heterogeneous outcome measures and limited number of high-quality RCTs available. Findings from this review showed that acupuncture improves symptoms despite the variations in acupuncture dosage, and provides beneficial effects in comparison with vitamin B therapies and no treatment. However, owing to problems with control group suitability and blinding, strong non-specific effects cannot be ruled out.
Acupuncture treatment significantly improves neuropathic symptoms in women suffering from chemotherapy-induced peripheral neuropathy after breast cancer therapy.
2019 The Oncologist Acupuncture for Chemotherapy-Induced Peripheral Neuropathy in Breast Cancer Survivors: A Randomized Controlled Pilot Trial Lu W, Giobbie-Hurder A, Freedman RA, Shin IH, Lin NU, Partridge AH, et al.
Randomised Controlled Trial Cancer Treatment Support Chemotherapy Peripheral Neuropathy
In this randomized pilot trial, women with stage I-III breast cancer with grade 1 or higher chemotherapy-induced peripheral neuropathy post adjuvant chemotherapy were tested. Patients were split evenly into two groups: an immediate acupuncture group and a control group. Those in the immediate acupuncture arm underwent 18 acupuncture sessions over 8 weeks before the treatment was halted. Conversely, the control group received the usual care over eight weeks before beginning nine acupuncture sessions across the same time span. Different parameters such as sensory scores, neurotoxicity, and pain severity were evaluated at the start, then at 4, 8, and 16 weeks post enrollment.
The results, which excluded any statistical references, showed a notable improvement in the immediate acupuncture group in terms of neuropathic symptoms, including sensory scores, neurotoxicity summary score, and pain severity score when observed at the end of eight weeks. No negative side effects were observed during the entire period. This indicates acupuncture as a potential therapeutic option for breast cancer patients suffering from chemotherapy-induced peripheral neuropathy.
The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy.
2015 Neurology Effects of Acupuncture on Neuropathic Pain: A Systematic Review and Meta-analysis Alexandra Dimitrova, Charles Murchison, Barry Oken
Systematic Review Bell's Palsy Carpal Tunnel Syndrome Chronic Pain
The majority of RCTs reviewed showed clear benefit for acupuncture over control in the treatment of diabetic neuropathy, Bell’s palsy and carpal tunnel syndrome. Acupuncture is probably effective in the treatment of HIV-related neuropathy and there is insufficient evidence for its benefits in idiopathic neuropathy. Meta-analyses of all diabetic neuropathy and bell’s palsy data using a summary estimate random effects model showed combined Odds Ratio (OR) of 4.23, p<0.001 favoring acupuncture over control for pain outcomes. The majority of trials demonstrate a positive effect of acupuncture over control condition in the treatment of neuropathy. Further more rigorously designed studies are needed to better characterize this effect.